Modern Wisdom - #555 - Dr Sarah Hill - The Psychological Impact Of Hormonal Birth Control

Episode Date: November 21, 2022

Dr Sarah Hill is a psychologist and professor at TCU whose research focusses on women, health, and sexual psychology. Women ovulate, and this changes their behaviour across their cycle. Unless they take hormonal birth control that is, in which case their behaviour changes even more dramatically in ways that no one anticipated and there is evidence to suggest that this might not just be temporary. Expect to learn why hormonal birth control can make women prioritise wealth in men, why women who come off are less sexually satisfied with partners they chose when they were on birth control, the relationship between taking the pill with anxiety, depression, bisexuality and stress, whether it's a good thing for women to have sex with men who they wouldn't marry and much more... Sponsors: Get 83% discount & 3 months free from Surfshark VPN at https://surfshark.deals/MODERNWISDOM (use code MODERNWISDOM) Get over 37% discount on all products site-wide from MyProtein at https://bit.ly/proteinwisdom (use code: MODERNWISDOM) Get 20% discount on House Of Macadamias’ nuts at https://houseofmacadamias.com/modernwisdom (use code MW20) Extra Stuff: Buy This Is Your Brain on Birth Control - https://amzn.to/3g8WCUF Follow Sarah on Twitter - https://twitter.com/sarahehillphd  Get my free Reading List of 100 books to read before you die → https://chriswillx.com/books/ To support me on Patreon (thank you): https://www.patreon.com/modernwisdom - Get in touch. Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact/  Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello everybody, welcome back to the show. My guest today is Dr Sarah Hill, she's a psychologist and professor at TCU who's research focuses on women, health and sexual psychology. Women ovulate and this changes their behaviour across the cycle, unless they take hormonal birth control that is, in which case their behaviour changes even more dramatically in ways that no one anticipated, and there is evidence to suggest that this might not just be temporary. Expect to learn why hormonal birth control can make women prioritise wealth in men,

why women who come off are less sexually satisfied with partners they chose when they were on birth control. The relationship between taking the pill with anxiety, depression, bisexuality and stress, whether it's a good thing for women to have sex with men who they wouldn't marry, and much more. This is probably one of the most important conversations I think have had this year. Obviously, it doesn't directly affect me, but then actually based on some of the stuff that Sarah taught me today, maybe it does. It's absolutely insane how wild the psychological impacts are of hormonal birth control, and I think it is nothing short of crucial that every woman is aware of just what happens

and what the options are and what some of the risks are and what some of the ways to mitigate all of this is. It's a, it's a, it's a really complex situation and I hope that you take tons and tons away from this episode. I found it fascinating, kind of terrifying, pretty insightful. So yeah, I really hope that you enjoy this one. Also, don't forget that you might be listening, but not subscribed. And over the next month, I've got some of the biggest guests that I've ever featured on the show. It is absolutely ridiculous.

And if you're not subscribed, you're going to miss those episodes when they go live. So if you want to support the show and if you want to make me happy and if you want to ensure that you're never missing an episode when it goes up, just press subscribe. Thank you very much. But now ladies and gentlemen please welcome Dr Sarah Hill. How did you get interested in studying birth control? Well, it's been most of my career studying women's sexual behavior and made attraction and partner choice and even done some work looking at women's sex hormones and the way that influences women's motivation and choice of dress and other things to that effect. And so I've always had an interest in women's psychology

and the different sort of biological components that contribute to like sort of what it means to be a contemporary female. But it was really going off of the birth control pill that got me interested in studying its effects on human psychology. What is the way that you would describe to a non-birth control taking person like myself the difference in your subjective experience of the world? For me, it felt like I woke up. So about three months after I discontinued using hormonal birth control, I started to notice that I was just had been feeling different recently.

I had more energy than I had before. I was going to the gym again. I was like noticing men and I was interested in sex in a way that I hadn't been in a really long time. I started downloading new music on my playlist for like the first time in like more than a decade. And I thought to myself this is like I just felt like I woke up. And I thought well this is a crazy way to respond to going off the birthing troll pill. And so I kind of chalked it up to just being me you oh, it just must be something else that's going on in my life

that's making me feel this way. But then I started to really start to dig down into the research. And it turned out that my experiences weren't all that unique and that there's been research that's been done now for several decades, detailing the different ways that hormonal birth control can influence women's psychology. I mean, ways that are very much consistent with the experiences that I had.

Okay, so before we get into how the pill affects behavior, what do we need to know about hormonal changes and how that influences behavior normally across a woman's ovulatory cycle? Right, well, yeah, I think that having some background in that can be really useful. And, you know, there's been research that's been done now for, I don't know, three or four decades as really looked at

women's ovarian hormones having a really profound role on the way that women experience the world. And even the activity and structure of the brain. So research in neuroscience, for example, has shown that as ovarian hormones change across the cycle, that actually changes the amount of functional connectivity in the brain, it changes the number of dendritic spines on our neurons. So our brain is this very plastic organism within our body that, you know, sort of changes

its structure and function over the course of the cycle. And a behaviorally, what the research finds is that, you know, during the time in the cycle when estradiol is high and the dominant sex hormone, there's a lot of research indicating that, you know, women have an increased preference for, or an increased desire for sex. They tend to engage in more sexual behavior at this time,

they tend to exhibit a heightened preference for cues related to men's masculinity at this time. And so during the phase in the cycle, which is what researchers usually characterize or call the periobulatory phase of the cycle, which happens usually between days like 9 to 14 So the cycle, which happens usually between days like 9 to 14 on average, if you're talking about a 28 day, ovulatory cycle, you know, the 28 day. What's what's day one? What happens on day one? Day one, you get your period. And so that's how you count forward, right?

So after you get your period, usually about we can have after you get your period, women will start to feel more energetic. They'll start to have a changes in libido where they're noticing that they're more interested in sex. They generally have more sex. They're more attuned to cues of, like I said, masculinity in men. They tend to just be more interested in men. At this point, compared to other points in the cycle, we have some at this point compared to other points in the cycle. We have some research showing that women reporting increased interest in music at this time, which is very much consistent with the experiences

I had downloading these playlists. With that corresponds to affluxuating levels of estradiol. And so when estradiol is high, it's almost like the brain is being directed toward everything related to sex. And the reason for this is, of course, during this time in the cycle, the body is getting prepared to release an egg. And this is a time when any sex that a woman might have can actually correspond to conception. And so, like, you know, the evolutionary process is sort of designed

the female brain in such a way that when estradiol is high and egg is getting ready to be released, and women are potentially pregnant, impregnable. That is not a word. It is now, don't worry. It is now that during this time, women are just really cute cute into sex and signs of sort of like genetic quality in partners and and then once the egg is released and within 24 hours of that women are no longer fertile and they start releasing the sex hormone progesterone, that hormone is then associated with a whole different set of sort of processes that the body is doing. In this case, to help increase the probability of implantation, right? And so it tends to make women sleepier, it tends to make them hungrier, it tends to decrease their interest in sexual behavior. They're not as interested in men. And during this time, it's because the body is solving

a totally different set of problems. It's like you can no longer become pregnant from sex. And instead, what you need to be doing is sort of staying safe and preserving your energy in the case of a possible implanted embryo, in which case pregnancy takes off. And so this is like for women who are not on the birth control pill who are cycling, the, you know, a menstrual cycle or what in the sciences, we like to call the

ovulatory cycle, since that's sort of the main event of the whole, of the whole act. It's a waxing and waning between these two hormones with estrogen being really high and dominant during the first half of the cycle. And that's generally associated with feeling sexy and energetic and being sexier to men. And then this progesterone dominant phase, which is more associated with sleepiness, hungreness, and for some women moodiness.

And a diminished interest in sexual desire. And so that is the state of a naturally cycling woman. What would you say to women that get uncomfortable hearing about the fact that they are kind of at the mercy of their hormones and they're being played like puppets with regards to their dry for sex, their dry for food and sleepiness and stuff like that. It could be taken as a patriarchal superstructure trying to keep women in their place as basically bearers of children or keepers of children.

Right. Yeah, yeah, yeah. I mean, look, the whole idea that hormones affect how we feel or what we do sounds sort of scary, especially given the history of people who are like sexist assholes, essentially trying to keep women from getting into positions of power by saying, oh no, they're too fickle because their behavior is affected by their hormones. But the fact of the matter is everybody's behavior is affected by hormones.

And everybody's moods are affected by hormones. And this includes both women and men. And so, you know, women, our primary sex hormones, estrogen and progesterone, change cyclically and very predictably, and with those predictable changes, so too come predictable changes in things like libido and mood. You know, for men, men's primary sex hormone is testosterone, and testosterone also affects men's behavior and mood. So we know that higher levels of testosterone

is associated with higher sexual desire, and we know that lower levels of sexual desire are associated with decreased motivation and lower mood. And for men, even though there's a stereotype that women are unpredictable and fickle because are cyclically changing hormones, you can actually predict what women's hormones are going to do, which means that you can predict how women are going to be responding to the world around them. For men in their primary sex hormone testosterone, this is not at all the case because men's levels of testosterone change all the time. They change based on the time of day, they change based on a man's relationship status. So whether he's partnered or whether he's single,

they change when he has a child, they change in response to seeing beautiful women, they change when their favorite political candidate or sports team win or loses, they change in response to even the presence of weapons. You're kidding me. Walking past a gun or playing with guns is going to increase men's testosterone. Yes, just being exposed to guns, being in the same room as guns increases men's levels of testosterone. So the idea that women are so fickle, and we don't know how they're going to react,

because their hormones change, and then that changes their mood and their behavior. Men's hormones change, men's hormones affect men's mood and behavior, but men's hormones change in a completely, their primary sex hormones change in a totally unpredictable way. And so the idea that somehow women are more hormonal than men is just absolutely not true.

We're all hormonal, right? And the idea that our hormones affect how we think, feel, and behave is not at all threatening to women or anybody because that's what they're supposed to do. If we didn't have our hormones, we'd be a disaster because our hormones are helping to coordinate all of the activities in our body. And if like, now is a good time for sex, like our bodies rolling out all the stops.

So that way we're all doing, you know, all the parts of our body are doing it together. Like, we're going to go and get sex now and the brain is on the same page and and the the genitals are on the same everything's on the same page moving in the same direction and you know if stress is on the scene you know or stress hormones then get all of our body coordinated and doing stress things and so the idea you know a hormonal involvement in behavior I mean it is just it's just explaining the biological mechanism or one of the biological mechanisms behind, you know, the experiences of being human.

Well, if it was the case that the only sex differences that we see are exclusively culturally imprinted, that would make being a man or being a woman basically a fashion choice. That would mean that there's no accrued wisdom from the unbroken chain of survivors that make up the fact that you're here right now. You don't get any of that, and it also means, I know that you talk about this, it would make women specifically kind of like puppets of culture, like just these gray bits of sludge that usually the patriarchy can come a calm and just shape into whatever form it is that they want them to be. Like there would be not no affirm for women to stand in terms of having a

nature. There is no female nature. Right, yeah, yeah, yeah, no. I think that there's a tendency sometimes for people to believe that the idea that sex differences are the result of, you result of the patriarchy and culture. It sounds on the surface as sort of this like pro-feminist idea. And a lot of people sort of adopt that, but it actually puts women in an incredibly submissive position of saying that we're just passive receptacles of culture and that

the things about us that make us unique for men aren't the result of inherited wisdom that we've accrued, as you noted, from our successful female ancestors having successfully survived and passed on their genes from generation to generation to generation, but that instead, it's just, you know, it's just that all of us were too dumb to question these rules that we were being taught and that we were just like, yes, we will do the cultural thing, yes we will. And that's not, you know, that doesn't put women

in a particularly empowering position. And in the exclusively culture explanation, also really misses, it's like missing one really critical piece of sort of explanatory, I don't know, where does culture come from? It's like culture is a product of the human nervous system. Culture was created by humans. That means that it is a product of our brain. Culture looks the way that it

does because of human's behaving over a really long spans of time. And the idea that men have been so powerful that they have created this whole cultural pattern that tends to be repeated, the whole world over, and that women for this whole and the entirety of human history have just been sitting in the back seat and letting men create culture and tell us what to do. Again, it's also just, you know, it, it, it, it, it's insulting. Yeah. It does. It treats women like malleable idiots and men like incredibly capable overlords. And I don't think that that's correct on, on either side. There was a, I had Carol Huvon on the show from Harvard. She did that book about testosterone. And she went to go and see red deer in Scotland, these

seasonal breeders. And when you're talking about the effect of testosterone on males, she got to see these seasonal breeders where for nine months of the year, these deer, male deer are just chilling with their friends, they're eating, they look not that dissimilar from the females, they haven't got the antlers, they haven't got any real aggression. And they're just with their boys just chilling out and eating, and then the women come into heat, and all hell breaks loose, and they start growing antlers, they start trying to kill everyone of the friends, they've just been chilling with a couple of months before, they start trying to kill them, they accrue this harm, they try and have as much

sex as possible, and then the women go back out of heat again, and it all changes. And you go, that is exactly what's happening with women, except for the fact that men, because you guys have got concealed ovulation, which happens so regularly that it wouldn't do for us to have fluctuations in testosterone associated with that. It means that we're just permanently in antler, have fights with your friends modes. That's it.

Yeah, yeah, yeah. Like some sort of media, the happy media, right? Where it's like you're neither constantly fighting with your friends, nor I'm chilling in your mom's basement playing video games. We're kind of like somewhere, somewhere in between those two things. It's interesting.

What about when the pill gets introduced then? What are the most obvious changes when it comes to behavior? I think that probably some of the most obvious ones are the changes in sexual desire, for example. That's a very common you know quote-unquote side effect that women get from taking hormonal birth control. And the reason for this is because you know the way that the hormonal birth control. And the reason for this is because, the way that the hormonal birth control pill works is, and essentially tells the brain to not stimulate the ovaries to produce any egg follicles,

or to mature any egg follicles. And the way that it does this is by giving a daily dose of the same hormonal message, which is, you know, what's contained in the pill, is a relatively high level of this synthetic progesterone, which is known as a progestin, and then really low levels of synthetic estrenon. And that message, getting that same daily message, either by the pill that you're taking, or whatever is being released by your vaginal ring, or the shot that you get in your arm, or whatever it is, that message, when you get it every day,

is essentially making the brain believe that it's in the ludial phase of the cycle, which is the phase of the cycle right after an egg has been released, and the body is waiting to see whether or not an implanted embryo is going to implant itself. And so, you know, during the second half of the cycle, when progesterone, for a naturally cycling woman, when progesterone is being released, the brain doesn't tell the ovaries, it tells the ovaries not to do anything, because it's like waiting to see what happens from that last one, before it tells it to start stimulating egg follicles again. And so getting that daily message, high-progesterone, progestin, low estrogen, shuts that process down. And this does a few things. Right, one, it prevents ovulation, which is great because that prevents pregnancy. Unfortunately, ovulation in addition to being something that allows for the possibility of pregnancy

is the primary way by which women produce their own sex hormones. And in particular, the process of maturing egg follicles and getting an egg ready to be released, that's one of the primary mechanisms by which the body produces estrogen. And so when you get that daily message every day of high levels of synthetic progesterone, low levels of estrogen, that's something that's not going to be particularly beneficial in terms of promoting female sexual desire. Because estrogen is the hormone of conception, is the hormone of sex. And so we know that all of those changes that we see in naturally cycling women where near high fertility when a neck is getting ready to be released, women have high sexual desire that the mechanism or the

driver behind that is estrogen. And so keeping estrogen levels really low is something that is not particularly great for women's libidos and it's definitely one of the things that women report experiencing at a relatively high rate. What about changes in make preferences, what they look for in men? Yeah, so this is really interesting. And so this is, you know, and I noted that, it's been about 20 to 30 years now that researchers

have been looking at the effects of women's ovarian hormones on their partner preferences, and as noted, when women are at the point in the cycle when estrogen is high, there's been a lot of research indicating that they tend to exhibit a heightened preference for cues to, in particular, masculinity. That's the one that seems to be the most replicable with women exhibiting a preference

for more masculineized male faces, more masculineized male voices, the scent of testosterone. So men with the high testosterone, if you like, have women's sniffing t-shirts, women prefer the scent of men with higher levels of testosterone. And so there's been a lot of research, this relinks estradiol to testosterone preference. And so more recently, researchers have begun to explore the idea that women who are on hormonal birth control, given that it keeps your own estradiol levels very low, and the synthetics are also, it gives you very low dose, that this might be associated with a decreased preference

for masculinity. And there is some evidence that is consistent with this. There's been research showing that women who are on hormonal birth control prefer a less masculineized male face, relative to what's preferred by the exact same women when they are naturally cycling. There's been research where they've looked at men who are in committed relationships, and they simply asked men and their partners, did your partner choose you when she was on or off of hormonal birth control and then they took the men's pictures and they sorted the pictures

into two piles, right, piles of pictures of men who were chosen by women who were using the pill and then a pile of pictures of men who were chosen by women who were naturally cycling and they had them evaluated by an outside group of evaluators who didn't know who was what and you know was under what circumstances. And what they found was that both in terms of objective measures of facial masculinity, which is something that you can look at using facial height to width because that's something that's associated with testosterone levels. And then just having outside evaluators

evaluates subjective masculinity of the male faces. What you see is that there are differences between those two groups of men and that the women are pardon me, the men who were chosen by women when they were on hormonal birth control. Those faces were seen as being less masculine and also sort of scored lower in terms of masculinity using the objective measures relative to the faces of men who were chosen by naturally

cycling women. And so all of this again is consistent with this idea that the pill could potentially impact our partner preferences. And we have some new research and I didn't write about this in my book because we're getting ready to publish this, but we've been working with natural cycles, which is a cycle tracking app, where they use basal body temperature to sort of track fertility. And a lot of women use it either as birth control to like see when they're ovulating and they're not having sex or they use it when they're trying to conceive, see when they're ovulating so they do have sex. And we sent a survey to their users asking them about what type of birth control they were on when they chose their partners.

And then we tracked the women's sexual behavior over the course of three cycles. Great, so this doesn't necessarily tell us anything about what, you know, tell us about your mate. But what we were able to do is look at whether or not women who chose their partners when they were on the pill are having less sex with those partners now that they're naturally cycling relative to what you see among women who chose their partners while they're naturally cycling and now they're naturally cycling. And that's exactly what we found. So we found that over the course of the cycle, that women who chose their partners

when they were on birth control or on hormonal birth control, they have less sex with their partners, even now that they're off of birth control, than their counterparts who were not on hormonal birth control the entire time. And what's really interesting about it is we also looked at differences in logged libido

between those two groups of women. And there were no differences in libido, right? So the women who chose their partners and they were on the pill, or women who chose their partners and they were off the pill, they both had comparable sex drive. It's just that the women who chose their partners when they were on the pill are having like translating that sexual desire into sexual behavior. Their partners less frequently than the women who chose their partners will naturally cycling. Why do you think that is?

I think that what the birth control pill essentially does by flattening are, you know, cyclically changing hormones and sort of minimizing the role of estrogen in terms of our partner choice and partner preferences and the types of qualities in terms of our partner choice and partner preferences and the types of qualities that we're attuned to when we're choosing mates. I think that it sort of downplays the importance of sexiness in a women's partner choice. And I think that it's just sort of nudging that

in terms of like the, you know, women are making choices about a partner, you know, you have to make a balance. Like, okay, do I want, you know, somebody who's Like, okay, do I want somebody who's really good provider, do I want somebody like with really interesting personality, do I want, we have to sort of pick and choose. And I think that when you have your HPG or your brain ovarian access shut down

and you're not experiencing all of the things that estrogen does for women's sexual desire, I think that it makes you downplay the importance of sexiness in your partner choice. And I think that it's like you tend to go after the more intangibles or pardon me, the tangibles, right? Like, okay, is this person going to be a good provider? Is this person stable and emotionally stable

and so on and so forth? And there's some evidence that's consistent with this. Like, there've been studies where they looked at how satisfied women are with different aspects of their relationship based on whether they chose their partner when they were on or off the pill. And what they find is women who chose their partners while they were on the pill report more satisfaction with things like their partner's financial resource access. Because they're going to have assessed them with great scrutiny around those things, but perhaps sacrificed for stuff like with things like their partner's financial resource access. Because they're going to have assessed them with greater scrutiny around those things,

but perhaps sacrificed for stuff like attraction, masculine dominance, maybe status as well, would perhaps be a little bit less important. Yeah, yeah, and nobody's looked at those last couple of like the status questions. They did look at sort of like sexual desire and that sort of thing within the relationships. And of course, you know, the women who were naturally cycling reported being more satisfied with the sexual aspects of their relationship. And the women who chose their partners on the pill were more satisfied with the financial

provisioning sort of cues in their relationship. And I think that what it does, I think it just sort of tilts the hand in terms of like what are you going after and for better and for worse. There can be that it's not necessarily good, it's not necessarily bad, it's just different. Which is part of the reason I wrote the book, I think that it's just important that we know what we're getting into when we go on the birth control pill. Obviously one of the potential scenarios that you could see happening here is that a woman gets into a relationship with a guy while she's on birth control, comes off birth control and finds that the dreamy relationship, maybe she's coming off birth control because they're

about to be married, maybe they've got married, and then I'm going to try for a child and they haven't been together while she's been off-birth control before. And she finds out that the dream relationship she was in might not be quite as attuned to what she wanted or was attracted to. So I can imagine that going off-birth control can cause a lot of turmoil within relationships. Yeah, possibly. And that's a really provocative idea, and it's one that researchers have begun to explore and They found some sort of mixed results on this, but one of the most

Sort of carefully done of these studies was one that was a longitudinal study in married couples and they looked at that very question like like what happens when you have a married couple and what happens when you have a married couple and the partners met when the woman was on hormonal birth control and now she goes off of it. And what they found was that when the women discontinued hormonal birth control, it did lead to changes in sexual and relationship satisfaction within the diet and the women reported changes in both of those things,

but it turns out whether it made that worse or made it better, dependent on how attractive her husband was. And so what they found is that for women who were partnered to really attractive men, when they went off of hormonal birth control, they reported an increase in their sexual desire and an increase in their attraction to their partner. And that's exactly what you'd expect estrogen to do. It's like, all of a sudden, estrogen is back on the scene.

It's like, oh my gosh, here's my libido and sex. And this is wonderful and hooray. But for women who were partnered with less attractive men, what they found was the opposite. And that was that they reported a decrease in relationship satisfaction, and a decrease in sexual satisfaction and sexual desire in their relationship. So women who have been using the more objective,

tangible metrics of success in order to judge their partner may have discounted more so the masculinity in the way that they look. But that doesn't necessarily mean that they haven't got with a guy that is very masculine and very attractive. It necessarily mean that they haven't got with a guy that is very masculine and very attractive It just means that they haven't prioritized that they then come out of this hormone-induced

Stupid and then on the other side of that they go, oh holy fuck. I'm actually in a relationship with a really attractive guy Look at how advantageous that is and now I can have loads and loads of sex obviously. I'm being exaggerating and also The same thing happens on the other side. I've been having a lot of conversations about what David Buscault's the mating crisis at the moment, this sort of imbalance between available guys that fit the characteristics that hypergamous women need and the ever-increasing group of high-performing women. I wonder whether the increased access and use of hormonal birth control influencing how objective the metrics are that women look for in men with regards to education, employment, future prospects and stuff like that is worsening this hypergamous nature at the moment and also

meaning that apps like Tinder and Hinge, which are very easy to put on what your job title is, what your education level is, so on and so forth, I wonder whether this is creating a hormonal profile in women, which further predisposes them to choosing these types of objective metrics. Yeah, no, that's really interesting. I think that that's a fascinating possibility. I mean, and how could it not? I mean, it's like, we already see the way that that hormonal birth control.

I mean, we see how it's affecting women's achievement, you know, since the pill was made like legally available to women, the number of legally available to single women, which was in the early 1970s, late 1960s, what you see is that the number of women who started doing things like applying to graduate programs, to law school, to medical school, to business school, it went up by like a thousand percent. And it was just because women now could be sure that if they started that program, they could finish. The employers as well, presumably, would be more certain as well? Yeah, and so it's just like, it just gave women the ability to plan. I mean, it's, you know, used to be for like, people like my grandmother, it was like the idea of going to graduate school would just be stupid, because she, unless she was, you know, like totally changed. That's a little bit, yeah. Yeah, the entire time that she was doing it,

she was probably gonna have to give it up because she was pregnant at some point. And so for my generation and younger generations and women who came before me who've also had access to this, like what a tremendous thing it's done for us in terms of allowing us to make plans and achieve. But because of that, you do have this like little bit of a mating crisis.

And I have another little nugget for you to like chew on while you're thinking about this with the pill and the mating crisis. And this was something that was actually brought, do you know who, do you know Dave Asperus? Yeah, the like health guy. Yeah. Yeah, yeah, yeah.

So I did his podcast and he's like a really smart guy and we were talking about my book We're talking about the pill and this was his idea and I think that he's like totally onto something because it's really It's really brilliant. I'm really interesting But you know part of the meeting crisis, you know part of it is that women are achieving so much, right? So like that's part of it But the other part of it is that men are just totally floundering. I mean, just, ooh, circling the drain. There is some research indicating that men's testosterone, we are not red deer. Our species are not red deer, but men's testosterone levels do seem

to be sensitive to the presence of like fertile women, right? So, men, they're spent studies where they have men, you know, having piped in the scent of ovulating women or women during the luteal phase. And you see that testosterone levels seem to be sensitive to cues of female fertility. And so what Dave had suggested, and I thought was so interesting, was we have so many women on hormonal birth control, so much ovulation being suppressed,

meaning that there are so few cues to estrogen, like sort of in the air, that could be that men's lack of achievement motivation is in part driven by the fact that their testosterone is in the toilet because of the lack of sort of ovulating women to inspire those higher levels of tea. And as you know, testosterone levels are at a ridiculous low. One percent per year, it's declined by since 1980. I mean, think about that. And yes, Zenoestrogens and yes, so beastly.

I mean, there's a lot of... Microplastics and thalates and more time inside and blah, blah, blah. Yeah, all of that. But even, you know, no matter what they control for, they're still some like factor X out there that's contributing to these low levels of testosterone. So I'm going to throw out there as a possibility, the idea that maybe it is a lack of estrogen cues. I think that that makes a lot of sense. I mean, roll it forward even more and think about the fact that women who are on birth control that then

urinate into the toilet, which then gets into the water supply, which then increases the amount of estrogen that's supposed to be consumed by men. No idea if there's any truth behind that at all, but if it's the case that taking the pill, women who take the pill are sociosexually slash ferrimonally influencing men's testosterone in terms of the fertility cues, and also biologically,

hormonally, internally influencing men's testosterone. Like, you know, roll on top of that poor sleep and higher levels of neuroticism, people spending time in the house, all that sort of stuff. Like, yeah, that's gonna drive testosterone down. Now, the fascinating thing is that women who take hormonal birth control are priming themselves for the kind of men that have lower testosterone. So it's both the cause, it's like the demand and the supply of the market for

this up until the point in which they come off it. Right. Yeah. And it's like they want the provisioning, right? Like one guy who's going to be a, but that's also made as driven by testosterone. You know, we know that men's testosterone levels are associated with like mating success and all that on the one hand, but it's also associated with achievement. You know, men who are CEOs and presidents and you know, in high status roles,

that's testosterone too. And so it's like in some ways, like we're also shooting ourselves in the foot, right? in high status roles, that's just a strong too. And so in some ways, we're also shooting ourselves in the foot. It's like, why aren't there any good men around who are achieving things and being successful and maybe there has something to do with what's happening with women's sex hormones? Really fascinating idea. So interesting. Didn't you have a quote about, without women,

all the power and money in the world would be meaningless? Yes. Yeah. I think, well, there's a fascinating question to be asked about whether it is a good idea for women to have sex with guys who don't have dad-like qualities. Basically, that up until this point, up until the pill was readily available, for the most part, sex was kept until marriage.

I'm sure there was sex outside of marriage, there were sex workers and stuff like that. But for the most part, the bar that men had to get over in order to get into a woman's pants was significantly higher. What is asking the father for the daughter's hand in marriage? What is that? You're going through a final checkpoint of presumably one of the highest scrutiny people in this woman's world to ensure that you have met the criteria. And the point being that if a lot of is asked of men

in order for them to get sex, they will meet that standard. If you need to be a pillar of the community with a good job who looks after his health, who doesn't have a bad record with the local community, who all of the things traditionally that men would have been asked to do, that's the case. If what you're asking of men now, because the price of having sex for women has been reduced down so much if what you ask of men is basically to be

in the right place at the right time at the end of the night in a nightclub. Right, yeah. Men will meet that criteria appropriately as well. Now, I'm not saying that we need to completely withdraw bodily freedom from women to be able to control their own like ovulation and whether or not they're going to have children.

But I do think that those, interesting question to be asked, like, is it a good idea for women to sleep with guys that they wouldn't want to be in a relationship with or to sleep with guys that wouldn't make good dads? Because you can, as you continue to drive the market price of having sex with a guy down, increasingly men will meet that criteria over and over again. And then you end up with questions being asked like, where are all the good men at? Right, yeah. No, I mean, you're right. It's like, men will rise to whatever standard is set by women in order to get a sexual

access. And sex has been an incredibly powerful motivator of male behavior, you know, since the dawn of time. And that quote about, you know, without women, all the power and money and status in the world would be meaningless. It's something Aristotle O'Nassus said. I mean, there's so much truth to that. And that is that for men, I mean, there's so much truth to that. And that is that for men, getting sexual access is something that isn't incredibly motivating force in a boy's life as he's sort of going through puberty

and the pueriddle transition and then a man's life. And when women don't require a lot of men in order to consent to sex, it does men will sink to whatever low standard is set and do sort of like what's minimally necessary in order to get access to the partner that they want or the partners they want, but not much more. And so the idea is, you know, that, and I write about this in my book, and it's, and this isn't, again, like sort of as you noted,

and I want to just make sure to hasten to add. This isn't to say that women are somehow responsible for men being lazy asses. This isn't like, that's not our cross to bear. It's instead just talking about, when we think about the types of cultural changes that have happened as a result of the birth control pill, this is possibly one of them. And that is that the birth control pill by allowing us to know that men that we have sex with

aren't going to be fathers of our children, it allows us to have casual sex in a way that we've never been able to have throughout history and not have to worry about the long-term consequences. And as you noted, this tends to shift to women's preferences in their choice of partners in ways that are very much skewed, not so much about like, is this person a good provider and a good dad, but more in terms of like, is this person sexy and might they be interesting for the evening? And so, and that person might not have achieved anything.

And so, one of the things that the pill may have done by allowing, by allowing shiftless men access to sex is reinforced shiftlessness because if you can get laid, this is what I always say and I'm talking to my grad students about this. If you can get laid while you're living your mom's basement needing Cheetos, why would you ever do anything different? You know, you're playing video games and mom's basement and you're getting laid?

I think most guys are like done. Well, I had a conversation with Richard Reeves and Scott Galloway and Roy Balmeister over the last few months and they have blown my head off about young male syndrome and about why we haven't seen roving bands of young guys pushing over granny and causing problems. And it's a combination of getting fake signals of camaraderie and achievement through video games and Diana Fleishman's idea of uncanny vulvas that they're getting fake cues of sexual fitness reinforcement from porn online. Now if you have been one of the guys that by fortune of charisma or good looks or good social circle or whatever,

is managing to bypass the porn one and get casual sex, but still with this, it's going to cause young men to not need to develop a lot of the things previously that would have been asked of them. But I gotta tell you about a story of a girl friend of mine who is a mostly lesbian bisexual and she usually sleeps with women. That's her thing, but she also sometimes sleeps with men. And I was out for dinner with her and I was mentioning it, I was going to have this conversation

with you. And she said, well, it's really interesting thinking about the way that coming off the pill change. And she spoke about a lot of the stuff that I'm sure we'll get into to do with the changes in stress and the depth and color of her emotions and things like that. Then she said, one other thing that I noticed when I came off the pill was that for one week out of every month, I was straight again. That is so fascinating.

I guess I can guess which week of the month it was. Ha ha ha. Have you ever come across that before? Yeah, so that is something that I've heard from, I can't even begin to tell you how many women I've heard that from. I've heard from a lot of bisexual women who get nudged one way or the other, depending on where they are in the cycle.

I've heard from women who thought that they were bisexual and then went on or off the birth control pill and then had that change where they were either completely straight or thought that they were completely lesbian. So was there a, did you manage to find a significant swing in one way or the other? You know, it's really interesting because for most, the thing I've heard the most, but I've heard it all most, the thing I've heard the most, but I've heard it all, but the thing I've heard most frequently is that they become a little more straight when they're off the pill. So, again, we're looking at the highest rates of bisexuality ever amongst women right

now, but we're also probably looking at the highest uptake of hormonal birth control ever. So, how many of the things that we're seeing at the moment uptake of hormonal birth control ever. So how many of the things that we're seeing at the moment, even from men's behavior, is being influenced by the pill? I know. I mean, exactly. I mean, exactly. Yes. I mean, the idea, you know, we've researchers have long suspected a role of sex hormones, like steroid sex hormones, in terms of sexual preference, right? And the story that you just told, and the stories I've heard from women

are very much consistent with hormonal nudges in terms of preferences. And for some women, it might just nudge them right over the borderline into bisexuality and some women, it can nudge them right over the side from being bisexual to being fully heterosexual, and some women it nudges in the other direction. And I actually had this idea,

because after I'd heard this story so many times, I started thinking about late in life lesbians. And there's this tendency, and culturally, we tend to think about this as just being something where women sort of get tired of all the bullshit being involved with men and that they're just looking for a companionship and then they start to form these close and even sexual relationships with other women. But then I started thinking about menopause. And the menopausal transition is this other period of hormonal disruption, where you

go from a naturally cycling state, where you have this waxing and waning of hormones, including this big surge of estrogen that surrounds the pariobulatory window that's associated with an increased preference for masculinity and maleness and just that sort of thing. And all of a sudden, over time, when our ovarian hormones begin to really rapidly decline, estrogen levels are very low in postmenopausal women. And I started thinking about latent life lesbians. And whether that might also be something that's emerging as a result of an actual hormonal nudge, where it's sort of nudging women out of the domain of heterosexuality or bisexuality

into this sort of different, made preference state. Well, think about it this way. Let's take grandmother hypothesis, right? Why is that women go through monopause at all so that they can contribute to the rearing of children while not contributing more children that need to be reared with one of the explanations that you have for why lesbian women exist at all, which is kind of like a female on female pair bonding,

alloparenting agreement type scenario. If you combine those two together, I mean, what better way for grandmother to ensure that her and some of the other women that she needs to look after her children and grandchildren are bounded together sufficiently well, that while the guys are out hunting, wildebeest, or whatever it is that they do, the women get it on a little bit, you know? Yeah, yeah, yeah, no, it's such an interesting idea. It's so interesting. I find all that so fascinating. So fascinating.

What about the relationship with suicide and depression and stuff like that from women that are on birth control? Yeah, so it seems pretty clear now from the majority of the evidence that's been coming out in the last, especially in the last decade, that going on hormonal birth control can be linked with an increased risk of anxiety and depression. And this risk seems to be

particularly pronounced in adolescent women. So there's been research looking at the increased risk of, you know, going on antidepressants as a function of hormonal birth control pill use, diagnosis of anxiety and depression, suicide risk as you noted, and what all of this research finds is that being on hormonal birth control is linked with an increased risk in all of these different outcomes, but particularly for young women.

And so in these studies, they categorize young women, these adolescent women as being women or 19 and younger. For these women, the risk of anxiety and depression, for example, in some cases, is almost triple what it is for adult women. That's just due to their age. Just due to their age. And nobody knows exactly what the age factor has to do with it except that the brain is still developing during this time.

And during brain development, post-pebriddle brain development is organized and coordinated by sex hormones. And so you can imagine the brain, the adolescent brain, is incredibly sensitive to changes in sex hormones during that time, because that's what's coordinating puberty, you know, pubertal development. And so the idea here is, you know, that the sensitivity to those hormones during that period is probably what's responsible for it, but it also raises the question of whether or not there's long-term changes then.

Are you locking in a more infantilized or juvenile or less developed or abnormal type of protein folding in the brain or brain structure generally? Right. That might increase the woman's risk, for example, of mental health problems throughout their lifetime. You just locked in this propensity for depression and anxiety. Yeah. And there was a there was a study that was just published, I think, about two years ago now, that showed that women who were ever users of hormonal birth control during adolescence, after they go off it, are still at an increased risk of developing

major depressive disorder that continues throughout their lifespan. And there hasn't been very much research on the long-term effects of hormonal birth control pill use during adolescence. But this is something that, I mean, it seems criminal to me that they prescribe it as frequently as they do to really young women for things like acne, for example, or period cramps, or things that aren't nearly as serious and sort of consequential as fertility regulation. And there's been almost no research

on the long-term effects on brain development when the brain is still developing. And given that study showing the increased risk and major depressive disorder, I think that we need to be more cautious and we need to see more of that type of research being done. Well, I know that there's a concern around melatonin ease in sort of pre-pubilty children,

because melatonin is used to help people fall asleep, but melatonin is also one of the mediators of the onset of puberty. So melatonin is also one of the mediators of the onset of puberty. So melatonin levels influence that. So if you're giving your child some melatonin gummy, you can actually be affecting when they hit puberty, whether they hit puberty, the cascade of hormones that's going to occur due to that. And yet no one's thinking twice about putting their daughter on to hormonal birth control.

I suppose there's another relatively difficult risk. It's probably gonna be a conversation between daughters and mothers or daughters and mothers with fathers sat on the couch being silent, I guess. But for the most part, there is a choice here, perhaps to be made between do you want to roll the dice with a young impulsive child who is going to begin to become sexually active at some point within the next half decade and maybe hasn't learned some of the lessons

that her mother has done about safety and security and so on and so forth. Or do you want to potentially put them in a situation that is going to lock in a suboptimal type of brain development? I mean, that's a brutal decision. How are you supposed to get to that knowing all of this information? Yeah, no, I think that it's such a, it puts people into a corner for sure. And in fact, I have a teenage daughter.

And this is something that I talk about with my friends all the time. It's like, what do we do? Like, what are the options? There aren't good options. And so that's just another reason that having all this information out there is so important, because what people decide

is the best option, or the least worst option, which is often, like what it is, is gonna differ for everybody. We're all gonna land on a different square when it comes to making this type of a decision, which is why I think it's just another reason it's so important to put all the information out there. So that way whatever decisions are being made or being made based on all of the information.

Yeah. Also Jonathan Height and Greg Glucayano's work about the coddling of the American mind. Obviously in that one of the things that they talk about is this rampant increase in anxiety disorders amongst young girls, young-ish girls. And it's completely in line with the introduction of Instagram and so on and so forth. And the intracexual competition and the way that women do it and men do it, females and males, it's very very different and it means that females can be more manipulated more easily through these sorts of platforms because they're more likely to do the

back bite eat stuff and they're going to feel it more blah blah blah. Has anyone controlled for the fact that hormonal birth control use is going to be continuing to ramp up at this time. What happens if you discount the base rate that comes from hormonal birth control use? Yeah, no, I think that that's a really great question and I don't think that anybody is probably thought to do that. I don't think that it's too easy to point the finger

at social media and I think that people get so nervous about talking about the potential consequences or side effects of hormonal birth control just because of how important it is for women, especially in this sort of dystopian post-row era that we're living in. I think that there's been a fear that if we say something bad about it, that it's going to be taken away from us, or people will become afraid of it, or that we can't hold on to conflicting information, like that we can't simultaneously hold that birth control is really important and that it's

played this huge role in terms of women's upward social mobility and economic independence. But that also, it can have some really shitty side effects and it comes back brain development. And it's like, I think that we're smart enough to hold both of those two things for me. No, almost almost no one on the internet is smart enough to hold two different conflicting ideas in their mind at one time. If you go on Twitter, like, this is exactly what you see, right? Like the complexity of the truth is inconvenient for both sides. And that you're totally correct. And it's one of the reasons that I really appreciate the audience that I've got on Modern Wisdom

and also everybody else that listens to Longfone podcasts because you have to be able to take multiple opinions throughout a single piece of content that's very, very long that you're going to both agree and disagree with. And the pace is so much more naturalistic and pedestrian, even at two-time speed. It's nowhere near as close as as TikTok or Instagram or Twitter. And it means that you have time to sort of marinate and the ideas and go, okay, well, that's, what do I actually think about that? Is it a knee-jerk reaction?

Where's this coming from? So, and so forth. So, I had Jamie Crems on the show last week and she taught me about the female rivalry hypothesis for concealed ovulation. Are you familiar with this? Yeah, yeah. It's just, it's not the idea that women have concealed ovulation essentially to prevent themselves from being targeted by other women unfavorably because I've other women saw that they were fertile, that they would like essentially murder them in their sleep. So, like... A number of things. First off, murder them in the sleep.

Secondly, like, socially try and mess with their ability to find mates, but also that if you know when a woman is about to ovulate, because she's bleeding, or she is like showing a visible signs of being in ovulation, if you push them sufficiently hard, apparently you can actually mess with the release of the egg overall as well, that you can actually cause it to not happen. So this is, you know, the why is it that women have got concealed ovulation is a question that's been asked for a long time, and there was this theory put forward, which is it increases pair bonding between men and women, because if you don't know when the woman can get pregnant, you need to have a lot of sex, which increases the per bond because you've got this difficult baby that you need to look after for the next

12 to 15 years before it can do things on its own, which means that the man and woman actually bind together. She controlled for that seems like it doesn't work quite so well. Female rivalry hypothesis is super interesting. Yeah. a well female rivalry hypothesis is super interesting. How effective are men and women at picking up on when women are ovulating generally at the moment, given the concealed ovulation and all the rest of the stuff? Right. There's a lot of research that seems to suggest that there is a preference for ovulating

women. I don't think that what's interesting about it is that it doesn't seem like anybody's able to mentally articulate like, wow, I bet she's fertile or, you know, like she's ovulating. But there is a lot of research that indicates that, you know, we find women more attractive when they're at high fertility compared to when they're at low fertility. And women generally feel sexier, they walk sexier, so they've done studies where they videotape women when they're walking at high and low fertility, and then they just show their silhouettes to outside evaluators, and they walk sexier. And so I think that there's a lot of evidence

that we're able to pick up on these cues and that we like them, but like in terms of identifying what it is we like, I don't know that, I think that there's some things that are better left to our unconscious mind. And I think that that's one of them. Does this mean then that by being on the pill, you are potentially going to change the way

that other people, both men and women relate to you. Absolutely, yes. And, you know, all of the, there's so much research that points toward women experiencing these, these subtle shifts in their behavior, in their physiology even, so we know that women smell differently at high fertility compared to low fertility. You know, we know that women dress differently at high fertility compared to low fertility. You know, we know that women dress differently at high fertility compared to low fertility. And a lot of these things are things that other people pick up on. And so if you're on hormonal birth control and you're not having these shifts that are

being induced by that estrogenic state that women get enter right prior to ovulation, I mean, there's no way that that isn't gonna change the way that women come across to other women and then also of course to potential partners. And that's, again, it's another thing that's provocative, right, that's provocative to think about the idea that being on hormonal birth control might change your desirability to partners.

Yeah. So women could actually be less attractive to men because they're on the pill, because the male, the back of the male brainstem doesn't know this is an elected reduction in fertility. The difference being this is just a woman that is significantly less fertile than that one over there who isn't on both control. Right, yeah, exactly. I mean, it seems to me like if I had to, if somebody were to say we're doing a study, we're looking at the desirability of this woman X. Right, and we're looking at her desirability to partners when she is near high fertility in the cycle. And then we're going to have her looked at, you know, this exact same woman. And they're in the same space and time, you know, because this is our magical experiment.

And she's on her mental birth control. There's no doubt in my mind that people would gravitate toward the naturally cycling version of that same woman. Like are these differences, you know, something that we would consider like, like, are they, you know, because I think they'd be significant, are they meaningful? I don't know, you know, it's like,

I don't think that a sort of, you know, a pill version of a woman compared to a non-pill version of a woman, I don't think that they would just get astronomically different types of partners. Like, wow, I went out the birth control pill, I was dating five and now I'm able to date sevens. I don't think it quite works that dramatically, but I do think that I do think it could potentially have implications for not only who women choose, but who also finds women

most attractive. And I think that's also something that's worth considering when sort of making decisions about the trade-offs that we make when we're on or off the pill. Why is the no male pill? Oh, gosh, there's a lot of reasons for this. But primarily, the reason is that women are the ones who get stuck with the pregnancy. In the case, it's like we are mammals

and females are the ones who bear the cost of pregnancy. So for us, we are significantly more motivated to put up with whatever bullshit comes along with our pregnancy prevention techniques than men are because for a woman, it's like, okay, I take this pill and it has this whole long list of side effects. My alternative is pregnancy. Okay, I'll take the shitty pill. For men, it's like, okay, I take this pill and it has this useless side effects and the alternative to it is, my partner goes on the pill. And so for men, they just are like, they won't put up with

it. They won't put up with the side effects that women will put up with because the costs aren't as high. And so I think that's one of the big contributors to the reason that a male pill has never really been able to take off. And another reason is, you know, it's not, you know, it would work well in the context of, and this is, again, it's the same rationale that's driving this.

But, you know, unless you're in a really long term committed relationship where you really know and trust your partner, most women, because they're the ones who have the huge cost associated with pregnancy, most women, especially in a casual relationship, would be sort of chagrined to trust their partner to be... Sure, darling, of course I'm on it. Yeah, of course I haven't forgotten to take my pill today. Yeah, exactly, exactly. And so I think that there's also an element of control there, which also, again, boils down to the fact that women are the ones

who are bearing the cost of pregnancy. And so it's like we're, you know, one, more worried about whether or not it's being used correctly. And so we're less likely to trust men to take it right. And two, men aren't as motivated to put up with the bullshit side effects that women have to put up with to stay on it because men's alternative is far less grave than ours. In summary, moving forward, what do you think is the future of birth control then? Because it seems to me at the moment, I have no idea, I had no idea until I started having chats in preparation for speaking to you today with some girls that

have been on the entire litany of different birth control options. And it seems like all of them have side effects, whether it's the coil, whether it's the once every three months injection, the little bar thing that goes on the inside of the bicep, whether it's taking the pill, the only one that seems to be relatively side effect free is the thermometer under the tone thing that you were mentioning earlier on, that you link them with an app and blah, blah, blah, but I think that there's a bit of trepidation for using that because to girls, it feels like less using that because to girls it feels like less certain somehow. Anyway, my point being, what's going on? We've listed today a pretty uncomfortable variety

of side effect, both to men and women, both physiologically, sexually, culturally, psychologically, short term, long term, during development, post-development. Is there anything that can be done? Yeah, I think that the future of birth control is going to be something that is not hormonal, but works just as effectively and works within the body. So just to give an example, but I think we need to get more clever about it. I think that sometimes there's a tendency for like procedural inertia, right?

Where it's like, oh, well hormonal birth control will work. So let's put all, let's focus on that. But it's like, all right, like let's scrap that idea, you know, like let's just forget about hormonal birth control for a minute and really get creative about what is it that's you know that produces sperm and what produces eggs and how to export themselves. What if, and this is a ridiculous idea, but don't try to invent this.

But I mean, what if there was a little shunt that you could put in a little, almost like a pinball machine flap that could be right outside the ovary and the fallopian tube or whatever that bats the egg out and just has a float around to get reabsorbed in the body. We just have no idea, you know, because everybody's been focusing on this one thing and I say, like, forget that. Like, let's like actually sit and think about the mechanics of conception and see if there's a

different route. And one thing that I heard about, and this was only about six months ago, and it was done in mice, and so this is obviously a very long way from humans, but this was a study that was done in mice where they found that if you block absorption of this like derivative of vitamin A that doesn't seem to do anything in the body except for help to promote um spermatogenesis, that if you block that in male mice that they can't produce sperm, and from what they can tell it doesn't seem to be used in any other systems in the body except for that. So if that ends up being true, which it might not be because you know our body is a mess of

spaghetti because of the evolutionary process that designed us. And so lots of things are used for lots of different reasons. And sometimes we don't even know what they are. So it may end up that this vitamin A derivative is also really important for heart valve function or something that we just don't know yet. But if it is actually just kind of the thing that it does and we're able to block absorption of that,

that's great, we're done. block absorption of that, that's great. We're done, you know? So it might be something that simple. And so that's going to be going into clinical trials as soon as they do a little bit more animal preclinical work on it to see whether or not it continues to work. But I think it's going to be something that gets away

from hormones and it sort of takes us from square one where we just ask ourselves, what are the mechanics of conception, what are the mechanics of spermatogenesis or uogenesis that we can potentially disrupt to really then disrupt the way that we're doing birth control. In a way that's going to have fewer side effects for men and for women. And the problem is that at the moment we have a solution which is pretty far from perfect but it kind of gets the job done. Right.

Okay, we'll just shelve that. We don't really need to worry about that. And let's get on with bigger problems, whatever they are. Right. Yeah, no, I think that there's this cultural perception that birth control as an issue for women is solved. And so part of the, you know, the big motivating factors for me writing the book was just like to really make people aware of the fact that no, this is not solved. And that there's a huge psychological

burden that women get under when they're going on birth control pills. And most women who are on birth control and have side effects from it. And when you talk to women about their birth control and you're like, hey, how do you feel about your birth control? They're like, I love my birth control. It makes my hair fall out and I don't have sex anymore. I get this weird bleeding cramping thing, but other than that, it's great. I love my birth control. Now, I am in a terrible mood all the time and I have all this anxiety and I'm on this antidepressant and that antidepressant and this and that and the other thing, my birth control is great. Not pregnant though. Yeah, not pregnant. I mean, and that's like how lower standards are because that's how little we have few options we've

been given as women. And so, you know, I think that we need to put more cultural pressure on the development of new types of birth control. And I think that, you know, I think that there's a lot of people in private industry that are doing that now. With the rise of quote unquote, femme tech, we're beginning to see that there is greater investment going into these companies that are going to hopefully be disrupting in a positive way the landscape of contraception for women. And also the concern that you have again amongst women that any criticism of birth control writ large is potentially rolling back further developments that have been rolled back relatively recently as well.

Yeah, no. I think that having conversations about birth control is always tricky just because of just how important it's been to women's sort of financial and economic independence, political independence, our ability to be able to care for ourselves. And so I think that people are pretty touchy about that. Yeah, I mean, if you'd been a guy and written that book, I'd be able to write that book as a guy, you know, I mean, it's just, it's too important to women. It's too important to women to have it be seen as something that's

under threat. And so, as I wrote my book, one reason I also wanted to be the person who wrote it is, I think that I was able to present things in a very balanced way where I talk about, you know, here is the range of potential psychological effects that you might experience, but this doesn't mean you should be not beyond it and it's bad because I don't think that anything is bad and nothing is good. It's like there's information and for each one of us, we need to sift through that information and then make decisions about ourselves because it's like I know what works for me, but that doesn't mean that I know what works for you. And so it's just really about providing all the information

in a really even-handed way, where I think, yeah, and sort of having that conversation in the context of just how important this has been for women in terms of putting us in the position that we're in now, economically and socially. All right, Sarah, let's bring this one home. Why should people go if they want to check out

the stuff that you do online? They can find me online at SarahEhill.com and that's Sarah with an H. And you can also find me on all different social, different social media platforms in my handle is at SarahE. Hill, PhD. Sarah, I appreciate you. Thank you. Thanks.

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